This year’s Medicare October 15 through December 7 AEP (Annual Enrollment Period) was a busy time for me and I’m grateful for the scores of individuals and couples who permitted me to help with their 2018 Medicare Supplement, Medicare Advantage or Part D Prescription drug plan selection. Still, as I am fielding calls for help after the deadline this is a good time to share some Q&As in case you, a neighbor or family member missed that deadline:
Q: I missed the deadline to make a change. Is there another option, or extension period, for me to choose a new plan for 2018?
A: Maybe. Some Medicare participants are eligible for what’s called a Special Election Period during which you can make a change to your Part D prescription drug or Medicare Advantage Plan outside of the October 15 – December 7 Annual Enrollment Period.
Q: Am I eligible for this Special Election Period?
A: Possibly. You may belong to one of two groups that have this Special Election Period; New York State EPIC or Social Security Extra Help.
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1) Medicare participants enrolled in a State Pharmaceutical Assistance program (SPAP) have one Special Election period per calendar year. The New York State SPAP is called EPIC. |
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2) Medicare participants enrolled in the Part D Extra Help program have the Special Election Period benefit, too. |
Q: Sounds great, Dan. What special circumstances are required for me to take advantage of this Special Election Period?
A: There doesn’t have to be a specific reason. Still, the two most common situations I see are:
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1) HMO Restrictions: An individual realizes their Medicare Advantage plan is a HMO plan with restrictions on seeing doctors outside of the HMO network and wants, instead, to join a PPO or Medigap / Supplement plan which allows you to see any doctor accepting Medicare. (Be sure to listen to Bob’s HMO story – click on the Monopoly Man(TM) card below.) |
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2) Many individuals receiving Social Security Extra Help become aware there are plans where the Extra Help subsidy could reduce their monthly premium to $0. |
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Click on Monopoly Man(TM) and listen to my short interview with Bob Foxworth. Bob used his Special Election period to change plans after his HMO refused approval to see a cancer specialist of his choice. |
Q: I’m not sure of my eligibility status, Dan; can you help me with my questions?
A: Yes, just call me at (518) 346-2115 or send me a note below and we’ll discuss your options by telephone, web conference or in person visit. And, during this Special Election Period, we may be able to identify a Medicare Advantage, Medigap or Prescription Drug Plan more suited to your needs – even though the December 7 deadline has passed.
